Reference no: EM133658374

Case: Veronica is the regional medical transcription manager for a large teaching healthcare organization with 8 acute care regional hospitals and 45 outpatient clinics. She is responsible for transcription timeliness and quality. She also does staffing, training and work distribution. All of the transcriptionists work from home. This healthcare organization has been purchasing a few local hospitals and merging them together as one entity.

At all locations, there is some documentation being done by front end speech recognition by the clinicians (which does not require a transcriptionist), but because of the 50% English as second language clinicians present in the physician resident population, their transcription is being performed by transcriptionists via back end speech recognition. This is due to the speech engine not being effective on heavy accents and the physicians having a lower threshold of English proficiency.

Veronica monitors each individual hospital and regional clinics' transcription volumes via separate transcription systems. There is an organization-wide EHR.

Veronica receives a call from a physician with complaints about transcription quality at Hospital A. Further, Veronica has been noticing a substantial increase in transcription turnaround times at Hospital A (time from dictation to completion of transcription). On investigation, she notices a quarterly transcription quality audit at Hospital A including the last three weeks, revealing a fall in overall quality, to substantiate the physician's claims.

When Veronica calls Patricia, the HIM manager at Hospital A, she learns one of the senior transcriptionists has fallen and badly broken her leg about a month ago. The leg became infected and the transcriptionist has had multiple surgeries and does not have a return to work date. Patricia was getting ready to contact Veronica because there are issues in dealing with the transcriptionist returning, learning over short periods of time of another surgery or another set back. Because the person who is out with the broken leg is a senior transcriptionist, she was effective on all of the work types, including more difficult operative reports. The three transcriptionists left do not have the same experience. In fact, one of them has been there for a year and has only learned how to do basic outpatient office notes.

Veronica and Patricia brainstorm and make the decision together to allow transcriptionists at the other hospitals to download from the dictation system at Hospital A to improve the transcription turnarounds and quality on the more difficult reports until the ailing transcriptionist can return. This is possible due to the organization-wide EHR. They also note performance benchmarking has not been done for transcription productivity since the last few mergers have been completed. Veronica has noted transcription volume reports that are printouts from the dictation systems and transcriptionist productivity reports that are available in the EHR.

Question 1. What possible brainstorming activities would Veronica and Patricia have engaged in to formulate their solution to the transcription backlog? Provide a rationale as to why you would choose that technique.

Question 2. Although the current problem has resolved, what is one way that they could prevent this problem from occurring in the future?

Question 3. What tools can be used by Veronica to create a weekly dashboard of hospital transcription metrics?